Background: Many observers believe that gastro-oesophageal reflux disease is more common among white individuals compared with Asians and Afro-Caribbean subjects.
Aim: To perform a systematic review regarding geographical and ethnic factors in the prevalence of reflux symptoms, endoscopic oesophagitis, hiatus hernia and Barrett's oesophagus.
Results: Differences in definitions and methodology make comparison between studies difficult. Overall, however, the community prevalence of reflux symptoms, as well as the prevalence of endoscopic oesophagitis, hiatus hernia and Barrett's oesophagus among patients undergoing upper endoscopy, were lower among Asian and Afro-Caribbean subjects compared with white individuals. There may also be a north-south gradient in the prevalence of gastro-oesophageal reflux disease among western countries. Gastro-oesophageal reflux disease may be moderately common in the Middle East. There are suggestions that the prevalence of gastro-oesophageal reflux disease is increasing in the Far East.
Conclusions: More data are required, especially from Africa, South America, the Middle East, and the Indian subcontinent. Suggestions are made regarding definitions and methodology to facilitate comparison between future studies from different countries.